Adobe Systems Physiology department 1 Arterial stiffness. Adobe Systems Physiology department 2 Oral exam questions ̶Arterial elasticity – significance ̶Arterial pulse, pulse wave Adobe Systems Physiology department 3 Factors of arterial stiffness changes ̶Elastin degradation ̶Collagen deposition ̶Endothelial dysfunction ! Adobe Systems Physiology department 4 Complications of the higher arterial stiffness Adobe Systems Physiology department 5 Pulse wave Reflected wave Forward systolic wave t [s] P[mmHg] Adobe Systems Physiology department 6 Pulse wave Reflected wave Forward systolic wave t [s] P[mmHg] t [s] P[mmHg] SBP/P1 P2 DBP PP=SBP – DBP mBP=DBP+1/3PP AP=P2 – P1 SBP – systolic blood pressure, DBP – diastolic blood pressure, P1 – pressure at peak of systolic flow, P2 – pressure of the reflected wave, PP – pulse pressure, mBP – mean blood pressure, AP – augmented pressure Adobe Systems Physiology department 7 Pulse wave at different vascular segments Adobe Systems Physiology department 8 Sex differences in mechanisms of arterial stiffness ECM - extracellular matrix; VSMC - vascular smooth muscle cell; eNOS - endothelial NOS; NADPH - NAD phosphate oxidase; BH(4) - tetrahydrobiopterin; SMC‐MR - smooth muscle cell mineralocorticoid receptor; AT1R - angiotensin II type 1 receptor; EC‐MR - endothelial cell mineralocorticoid receptor; ENaC - epithelial sodium channel. Adobe Systems Physiology department 9 Pressure wave reflection Adobe Systems Physiology department 10 Pressure wave reflection Adobe Systems Physiology department 11 Ultrasound measurement age IMTR (mm) IMTL (mm) Adobe Systems Physiology department 12 PWV measurement A highly compliant aorta has a relatively low PWV (< 6 m/s) Adobe Systems Physiology department 13 Ultrasound measurement (β – index). Adobe Systems Physiology department 14 CAVI measurement Adobe Systems Physiology department 15 CAVI measurement Adobe Systems Physiology department 16 t [s] P[mmHg] SBPP2 AP